What is vascularised lymph node transfer (VLNT)?
VLNT is a novel microsurgical procedure for the treatment of lymphoedema. The procedure involves taking lymph nodes with their feeding blood vessels (a lymph node flap) from an unaffected part of the body and transferring it into a limb affected by lymphoedema. The blood vessels are re-connected to blood vessels in the affected limb. How VLNT work is still unclear – it is thought the transferred lymph nodes encourage the growth of new lymphatic channels but this has not been proven. The procedure takes a few hours and patients often remain in hospital for 1-2 nights. Compression therapy is re-started a couple of weeks after surgery.
How effective is VLNT?
Mr Khan has recently published a study (click here) investigating VLNT efficacy in the treatment of 581 patients with cancer-related lymphoedema. The study, which was also published at the American Society of Clinical Oncology (ASCO), showed that VLNT can be effective in reducing excess limb volume by approximately 40% and episodes of cellulitis by 2 episodes per year. However, the study also showed that many studies on VLNT are of poor methodological quality randomised clinical trial data remains lacking.
Will VLNT give me lymphoedema in another part of my body?
Many lymphoedema patients often reach an equilibrium with their limb swelling and so balancing the risks versus potential benefits of surgical interventions for lymphoedema is critical and the decision making around this can be challenging. When performing VLNT a ‘reverse mapping’ technique is used to minimise the risk of donor site lymphoedema. A coloured dye is usually injected at multiple points in the area where the lymph node flap will be taken from. When raising the lymph node flap any coloured lymph nodes, which drain the limb, are left untouched to reduce the risk of donor site lymphoedema. In the study above, the rate of donor site lymphoedema was estimated to be less than 0.5%.
For more information on lymphoedema treatment options contact Mr Khan’s practice to arrange an appointment.